Letter to the Director
Communication strategies in intensive care units: ISOBAR and SPIKES
Estrategias de comunicación en las unidades de cuidados intensivos: ISOBAR y SPIKES
A. Medina Gamero
, M. Regalado Chamorro, C. Pizarro Moncada
Corresponding author
Universidad Privada del Norte, Lima, Peru
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Medina Gamero, M. Regalado Chamorro, C. Pizarro Moncada" "autores" => array:3 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Medina Gamero" "email" => array:1 [ 0 => "medrafa222@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Regalado Chamorro" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Pizarro Moncada" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Universidad Privada del Norte, Lima, Peru" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estrategias de comunicación en las unidades de cuidados intensivos: ISOBAR y SPIKES" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Communication and teamwork are fundamental tools to increase satisfaction and manage disease progression by improving adherence to treatment in the patient and their family. Both these elements help motivate, diagnose, and cure critically ill patients.</p><p id="par0010" class="elsevierStylePara elsevierViewall">One of the greatest concerns facing family members is the patient’s state of health and the medical treatment they receive in the Intensive Care Unit (ICU). This is why communication must be both therapeutic and effective at the personal and family level.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Various information handover techniques have been developed for this purpose, such as <span class="elsevierStyleItalic">briefing</span>, in which the care plan is quickly and effectively communicated, and <span class="elsevierStyleItalic">debriefing,</span> in which the attending physician reports on the treatment administered in the ICU. Staff attitudes to the handover of information will enhance the care process. Family members can also play an important role in treatment by transmitting positive emotions that mitigate the patient’s suffering at being separated from their family and indirectly help improve the patient’s health<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Given the importance of communication, ICU specialists must possess the verbal and procedural skills and practical knowledge required in specific situations, such as intubation and patient resuscitation. It is, therefore, of the utmost importance to implement specific guidelines for informing patients about their medical treatment and delivering bad news.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The first patient care tool in the ICU is the ISOBAR (identify–situation–observations–background–agreed plan–read back) information handover checklist. Communication can also be improved by implementing new patient-family support practices. For example, hospital staff should consider using telecommunications for this purpose, and appoint a social worker, nurse or other staff member to mediate between the patient and their family by placing telephone calls to the relatives of each patient in the ICU<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>. Video calls using digital applications can mitigate loneliness by allowing patients to both hear and see their family member. Another useful tool is the ICU diary, in which staff and family members write down observations and anecdotes concerning the patient<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The second strategy is the SPIKES (setting – patient’s perception – invitation – knowledge – exploring/empathy – strategy/summary) protocol for delivering confidential information in an organized manner in an appropriate environment<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In summary, appropriate verbal skills can be acquired and effective communication achieved using protocol-based communication strategies complemented by telephone calls, video calls and ICU diaries. This can reduce the anxiety and stress associated with hospital care and improve decision-making when delivering bad news to the patient.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0040" class="elsevierStylePara elsevierViewall">There are no public or private sources of funding</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interests</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interests" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Medina Gamero A, Regalado Chamorro M, Pizarro Moncada C. Estrategias de comunicación en las unidades de cuidados intensivos: ISOBAR y SPIKES. Rev Esp Anestesiol Reanim. 2022. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.redar.2021.05.006">https://doi.org/10.1016/j.redar.2021.05.006</span></p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "El proceso de información a los familiares en las unidades de cuidados intensivos: una revisión narrativa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. Regaira-Martínez" 1 => "C. 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